摘要
目的：观察危重病人强化胰岛素治疗后的的疗效。方法：将116例危重病人随机分为传统治疗组(CT)和强化胰岛素治疗组(IT)。CT组：当血糖＞11.9mmol／L,予诺和R笔芯皮下注射,控制血糖10～11.1mmol／L。IT组：当血糖＞6.1mmol／L,控制血糖4.4～6.1mmol／L。结果：CT组病死率达44.88％,远远高于IT组的12.07％；病人的ICU住院时间、使用呼吸机日数、每日6am的平均血糖、每日TISS-28评分均明显高于IT组(P＜0.05)；CT组每日胰岛素用量、HLA-DR、CD_4^+／CD_8^+明显小于IT组(P＜0.05)。两组并发症比较,CT组病人发生肾损害、输注红细胞、发热的人数均明显高于IT组(P＜0.05)。结论：强化胰岛素治疗控制危重病人血糖80～110mmol／L,能降低病人的病死率。
Objective： To observe effect of intensive insulin therapy in critically ill patients. Methods： One hundred and sixteen critically ill patients were randomly divided into conventional therapy group （CT） and intensive insulin therapy group （IT）. Patients with blood glucose larger than 11.9mmol/Landwhose blood glucose maintained at the level between10.0- 11.1 mmol/L was divided into CT group and patients with blood glucose larger than 6.1 mmol/L and whose blood glucose controlled at the level between 4.4 ～ 6.1 mmol/L was divided into IT group. Results： The mortality in CT group （44.83%） was higher than that in IT group （12.07%）. The days of hospitalized in ICU, number of day for using mechanical ventilation, the average blood glucose at 6 am. daily and TISS score daily in CT group were obviously higher than that in IT group. The insulin dosage used daily, HLA-DR, and CD4^＋/CD8^＋ were significantly lower than that IT group （P〈 0.05）. Conclusion： The intensive insulin therapy to control blood glucose at the level between 80 ～ 110 mmol/L can reduce mortality in critically ill patients.
出处
《温州医学院学报》
CAS
2005年第6期471-473,共3页
Journal of Wenzhou Medical College
基金
浙江省教育厅科研基金(20030930)
关键词
危重病
ICU
高血糖
强化胰岛素治疗
critically ill patients
ICU
hyperglycemia
intensive insulin therapy
